RALPH F JACKSON DO Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125025571

License Status

EXPIRED

Business

First Name

RALPH F

Last Name

JACKSON

Suffix

Business Name

RALPH F JACKSON DO

Original Issue Date

06/19/1990

Effective Date

06/19/1990

Expiration Date

06/21/1993

City

CHICAGO

State

Zip

60612

County

COOK

Specialty/Qualifier

Family Practice & OMT

Ever Disciplined

LastModifiedDate

09/22/2006